| NPI | 1215319140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 307875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125067824) |
| 208M00000X Hospitalist (Licence: OR MD190959) | |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2023-03-01 |